What do we want to know?

We sought to understand whether workplace health programmes (WHPs) are effective for improving health and business outcomes, and to identify the characteristics of WHPs that are thought to influence their success. To address these issues, we undertook a systematic review of three sources of evidence: systematic reviews examining intervention effectiveness; research on stakeholders’ views and experiences; and key workplace health policy documents.

Who wants to know?

This review was commissioned by the Department of Health to foster collaboration with key business leaders and workplace policy makers interested in supporting workplace health across small, medium, large and enterprise-sized businesses in England. The findings from this systematic review will be of interest to policy makers in workplace health as well as researchers, business leaders, workplace health professionals, workers and union representatives.

What did we find?

We identified 24 systematic reviews of WHPs which examined statistically the impact on a variety of outcomes, including mental health, weight management, absenteeism (and its costs), work ability and job stress. The reviews demonstrated that workplace health interventions are effective in improving health and business outcomes. The magnitude of effects on those outcomes is modest, suggesting that a reasonable impact potentially could be demonstrated for relatively low expenditure.

Evidence from 10 stakeholder views studies and 17 policy documents were integrated with evidence from systematic reviews to identify key characteristics of WHPs. Four characteristics were identified across all three evidence sources, suggesting that they could be implemented to good effect: ensuring the organisation’s financial commitment, ensuring the intervention is easy to begin and accessible, and fostering structures to promote social support. Five characteristics were identified in systematic reviews and views studies but have yet to be addressed by policy recommendations; these included the extent of policy integration, the importance of the implementer’s role within the company, the content of an intervention, whether the intervention is tailored or individualised, and issues related to acceptability such as hours offered and location.

Four characteristics were identified as important in views studies or policy documents but had not been examined in systematic reviews, suggesting a need for future evaluation. These included ensuring managerial and organisational support, establishing channels of communication and the providing tailored advice. The provider’s approach and the use of web-based technologies were identified as important, but in stakeholder views research only. Each of these characteristics can be implemented in a variety of ways, suggesting creative possibilities for the ways in which businesses could integrate them into employer-led workplace health.

What are the conclusions?

The findings suggest that employers can derive benefits from establishing WHPs, both for the business and with respect to their employees’ health. Interventions that are supported by organisational policy, focus their content on specific health issues and engage employees have been shown to be effective and are supported by stakeholder research and policy documents. Employers may find additional benefit if they pay close attention to and capitalise on the context in which a WHP intervention either is implemented or is received by participants. Finally, the impacts on health and business outcomes of many promising WHP characteristics have yet to be evaluated, and should be integrated into future WHP intervention evaluations.

How did we get these results?

Comprehensive searching of electronic databases and websites was carried out to identify the three relevant types of studies. Using framework synthesis, we combined evidence from the systematic reviews, views studies and policy documents by using a previously developed framework of characteristics potentially influencing workplace health effectiveness. Data analysis themes were then organised to produce tabular and narrative summaries of key characteristics of WHPs to produce an overall narrative.